最大体重与2型糖尿病发病关系的病例对照研究

A case-control study of the relationship between type 2 diabetes and the maximum body weight

目的探讨既往最大体重与2型糖尿病(T2DM)发病的关系,推论其与当前体重及胰岛β细胞功能和胰岛素敏感性的关系。方法178例T2DM家系患病-非患病同胞,其中T2DM97例,正常糖耐量(NGT)81例,评价胰岛素抵抗及胰岛β细胞功能,logistic回归分析既往最大体质指数(BMI)与T2DM的发病关系。结果两组既往最大BMI分别为27·6±3·8kg/m2和25·6±3·0kg/m2,差异有统计学意义(P=0·000);既往最大BMI与T2DM的发生呈正相关(OR=1·193,P=0·000);既往最大BMI与当前BMI显著正相关(P=0·000),T2DM组和NGT组的相关系数分别为0·861和0·867。随既往最大BMI的增加,血压、空腹胰岛素、胰岛素抵抗指数升高,胰岛素敏感性下降。结论既往最大BMI越大,T2DM发病危险性越大,当前体重也越大;超重或肥胖个体由于胰岛素敏感性下降导致T2DM发病的危险性增加。

Objective To investigate the relationship between the past maximum body weight and type 2 diabetes（T2DM）, and deduce it＇s possible relationship to current body weight and the current islet β-cell function and insulin sensitivity. Methods 178 compatriots with diabetic family history included 97 cases with T2DM and 81 controls（normal glucose tolerance,NGT）. The β-cell function and insulin sensitivity were evaluated. Logistic regression analysis was used to estimate the odds ratio （OR） for T2DM in relation to the level of maximum BMI. Results The mean past maximum BMI was higher in diabetic group （27.6±3.8） than in NGT group （25.6±3.0, P=0. 000）. Past maximum BMI was positively related to T2DM （OR 1. 193, P=0. 000）. Along with the increasing of past maximum body weight, the blood pressure, HOMA-IR and Fins increased and IAI decreased. The indexes reflexing istet β-cell function didn＇t change. The past maximum BMI positively correlated with current BMI in both T2DM and NGT groups, and the correlation coefficients was o. 861 and 0. 867 separately （all P=0. 000）. Conclusions The subjects with high past maximum body weight would have high current body weight and were in high risk for T2DM, which may be due to the action of the insulin resistance.